The World Health Organization Reporting System for Pancreaticobiliary Cytopathology.

IF 1.6 4区 医学 Q3 PATHOLOGY Acta Cytologica Pub Date : 2023-01-01 Epub Date: 2022-12-14 DOI:10.1159/000527912
Martha B Pitman, Barbara A Centeno, Michelle D Reid, Momin T Siddiqui, Lester J Layfield, Miguel Perez-Machado, Birgit Weynand, Edward B Stelow, Maria D Lozano, Noriyoshi Fukushima, Ian A Cree, Ravi Mehrotra, Fernando C Schmitt, Andrew S Field
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Abstract

The World Health Organization (WHO), the International Academy of Cytology, and the International Agency for Research on Cancer, with expert contributors from around the world, present an international approach to standardized reporting of pancreaticobiliary cytopathology. This reporting system is one of the first in a series from various body sites that mirror the WHO Classification of Tumours series and provides an evidence-based terminology system with associated risk of malignancy and diagnostic management recommendation per diagnostic category. The WHO Reporting System for Pancreaticobiliary Cytopathology (WHO system) revises the Papanicolaou Society of Cytopathology (PSC) system for Reporting Pancreaticobiliary Cytology published in 2015 and replaces the six-tiered system with a seven-tiered system: "insufficient/inadequate/nondiagnostic"; "benign (negative for malignancy)," "atypical," "pancreaticobiliary neoplasm of low risk/low grade," "pancreatic neoplasm of high risk/high grade," "suspicious for malignancy," and "malignant." The principal differences between the WHO and the PSC systems revolve around the classification of neoplasia. In the PSC system, there was a single category for "neoplastic" lesions that includes two groups, one for "benign neoplasms" [primarily serous cystadenoma] and one named "other," dominated by premalignant intraductal neoplasms (primarily intraductal papillary mucinous neoplasms) and low-grade malignant neoplasms [pancreatic neuroendocrine tumors (PanNETs) and solid pseudopapillary neoplasms (SPNs)]. In the WHO system, benign neoplasms with virtually no risk of malignancy are included in the "benign" category and low-grade malignancies (PanNET and SPN) are included in the "malignant" category, as per the WHO Classification of Digestive System Tumours, thus leaving in the "neoplasm" category primarily those noninvasive premalignant lesions of the ductal system. These neoplasms are divided by the cytomorphological grade of the epithelium into low risk/low-grade and high risk/high-grade, with distinctly different risks of malignancy. As with the PSC system, the WHO system advocates close correlation with imaging and encourages incorporation of ancillary testing into the final diagnosis, such as biochemical (CEA and amylase) and molecular testing of cyst fluid and bile duct brushings. Key diagnostic cytopathological features of specific lesions or neoplasms, ancillary studies for diagnostic and prognostic evaluation, and implications of diagnosis for patient care and management are discussed. In addition, the WHO system includes reporting and diagnostic management options that recognize the variations in the availability of diagnostic and prognostic ancillary testing modalities in low- and middle-income countries, where cytopathology is particularly useful and is increasingly available in the absence of histopathological services.

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世界卫生组织胰胆细胞病理学报告系统。
世界卫生组织(WHO)、国际细胞学学会(International Academy of Cytology)和国际癌症研究机构(International Agency for Research on Cancer)与来自世界各地的专家共同提出了胰胆细胞病理学标准化报告的国际方法。该报告系统是反映世界卫生组织肿瘤分类(WHO Classification of Tumours)系列的首批报告系统之一,它提供了一个循证术语系统,每个诊断类别都有相关的恶性肿瘤风险和诊断管理建议。世卫组织胰胆细胞病理学报告系统(世卫组织系统)修订了2015年发布的巴氏细胞病理学会(PSC)胰胆细胞病理学报告系统,并以七级系统取代了六级系统:"不充分/不足/无诊断意义";"良性(恶性阴性)"、"非典型"、"低风险/低级别胰胆管肿瘤"、"高风险/高级别胰腺肿瘤"、"恶性可疑 "和 "恶性"。世卫组织和胰腺肿瘤分类系统的主要区别在于肿瘤的分类。在 PSC 系统中,"肿瘤性 "病变只有一个类别,包括两组,一组为 "良性肿瘤"(主要是浆液性囊腺瘤),另一组名为 "其他",主要是恶性前导管内肿瘤(主要是导管内乳头状粘液瘤)和低度恶性肿瘤(胰腺神经内分泌肿瘤 (PanNET) 和实性假乳头状瘤 (SPN))。根据世卫组织消化系统肿瘤分类法,几乎没有恶变风险的良性肿瘤被列入 "良性 "类别,低度恶性肿瘤(PanNET 和 SPN)被列入 "恶性 "类别,因此 "肿瘤 "类别主要包括导管系统的非侵袭性癌前病变。这些肿瘤按上皮细胞形态学等级分为低危/低级和高危/高级,其恶变风险截然不同。与 PSC 系统一样,世卫组织系统主张与影像学密切相关,并鼓励在最终诊断中纳入辅助检测,如囊肿液和胆管刷片的生化(癌胚抗原和淀粉酶)和分子检测。该系统讨论了特定病变或肿瘤的关键细胞病理学诊断特征、用于诊断和预后评估的辅助检查以及诊断对患者护理和管理的影响。此外,世卫组织的系统还包括报告和诊断管理选项,这些选项认识到中低收入国家在诊断和预后辅助检测方式可用性方面的差异,在这些国家,细胞病理学尤其有用,而且在缺乏组织病理学服务的情况下,细胞病理学的可用性越来越高。
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来源期刊
Acta Cytologica
Acta Cytologica 生物-病理学
CiteScore
3.70
自引率
11.10%
发文量
46
审稿时长
4-8 weeks
期刊介绍: With articles offering an excellent balance between clinical cytology and cytopathology, ''Acta Cytologica'' fosters the understanding of the pathogenetic mechanisms behind cytomorphology and thus facilitates the translation of frontline research into clinical practice. As the official journal of the International Academy of Cytology and affiliated to over 50 national cytology societies around the world, ''Acta Cytologica'' evaluates new and existing diagnostic applications of scientific advances as well as their clinical correlations. Original papers, review articles, meta-analyses, novel insights from clinical practice, and letters to the editor cover topics from diagnostic cytopathology, gynecologic and non-gynecologic cytopathology to fine needle aspiration, molecular techniques and their diagnostic applications. As the perfect reference for practical use, ''Acta Cytologica'' addresses a multidisciplinary audience practicing clinical cytopathology, cell biology, oncology, interventional radiology, otorhinolaryngology, gastroenterology, urology, pulmonology and preventive medicine.
期刊最新文献
Reclassification of Urinary Cytology according to the Paris System for Reporting Urinary Cytology Correlation with Histological Diagnosis. Cytopathology of a newly described salivary gland neoplasm. A case report of microsecretory adenocarcinoma presenting in the parotid gland. Does The Diagnostic Performance Of The Pathologist On The Indeterminate Categories Of The Bethesda System For Reporting Thyroid Cytopathology Vary Between Pediatric And Adult Patients? Evaluation of a Cytology-Molecular Co-Test in Liquid-Based Cytology-Processed Urine for Defining Indeterminate Categories of the Paris System. Diagnostic and Predictive Immunocytochemistry in Lung Cancer.
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